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Peer-reviewedCC BY-NC-NDPostepy psychiatrii neurologii

Irreversible paraplegia due to transverse myelitis as a rare complication of CAR T-cell therapy in a patient with B-cell lymphoma.

  • Anna Lojko-Dankowska1
  • Tomasz Dynowski2
  • Michał Machała2
  • Anna Płotka1
  • Adam A Niezgoda3
  • Anna Wache4
  • Lidia A Gil1
4 affiliations
  1. 1Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
  2. 2Department of Neurology, Poznan University of Medical Science, Poznan, Poland.
  3. 3Department of Neurology, Poznan University Hospital, Poznan, Poland.
  4. 4Department of Hematology and Bone Marrow Transplantation, Poznan University Hospital, Poznan, Poland.
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Abstract

Purpose

To report a rare case of irreversible paraplegia due to transverse myelitis as a severe neurotoxic complication of chimeric antigen receptor (CAR) T-cell therapy.Case description

A 45-year-old woman with primary mediastinal B-cell lymphoma received axicabtagene ciloleucel. She deve-loped Grade 4 neurotoxicity with seizures requiring intubation. Upon regaining consciousness, she presented with flaccid paralysis of the lower limbs, sensory loss, and sphincter dysfunction. Magnetic resonance imaging revealed longitudinally extensive spinal cord lesions. Despite treatment with corticosteroids, anakinra, and intravenous immunoglobulin, no neurological improvement was observed. One year after the therapy, the patient remained in complete remission from lymphoma but was wheelchair-dependent, with persistent paralysis and spinal cord atrophy.Comment

This case highlights a rare and severe form of CAR T-cell-related neurotoxicity, manifesting as transverse myelitis in the absence of a marked inflammatory response. The refractory course and lack of standard treatment options underscore the need for greater awareness, reporting, and further research into atypical neurological complications of CAR T-cell therapy.

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Cite

BibTeXRIS
BibTeX
@article{lojkodankowska2026irreversible,
  title = {{Irreversible paraplegia due to transverse myelitis as a rare complication of CAR T-cell therapy in a patient with B-cell lymphoma.}},
  author = {Anna Lojko-Dankowska and Tomasz Dynowski and Michał Machała and Anna Płotka and Adam A Niezgoda and Anna Wache and Lidia A Gil},
  journal = {Postepy psychiatrii neurologii},
  year = {2026},
  month = sep,
  doi = {10.5114/ppn.2026.164944},
  url = {https://europepmc.org/article/MED/42898883},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Irreversible paraplegia due to transverse myelitis as a rare complication of CAR T-cell therapy in a patient with B-cell lymphoma.
AU  - Anna Lojko-Dankowska
AU  - Tomasz Dynowski
AU  - Michał Machała
AU  - Anna Płotka
AU  - Adam A Niezgoda
AU  - Anna Wache
AU  - Lidia A Gil
PY  - 2026
DA  - 2026/09/22
JO  - Postepy psychiatrii neurologii
DO  - 10.5114/ppn.2026.164944
UR  - https://europepmc.org/article/MED/42898883
AB  - Purpose  To report a rare case of irreversible paraplegia due to transverse myelitis as a severe neurotoxic complication of chimeric antigen receptor (CAR) T-cell therapy.Case description  A 45-year-old woman with primary mediastinal B-cell lymphoma received axicabtagene ciloleucel. She deve-loped Grade 4 neurotoxicity with seizures requiring intubation. Upon regaining consciousness, she presented with flaccid paralysis of the lower limbs, sensory loss, and sphincter dysfunction. Magnetic resonance imaging revealed longitudinally extensive spinal cord lesions. Despite treatment with corticosteroids, anakinra, and intravenous immunoglobulin, no neurological improvement was observed. One year after the therapy, the patient remained in complete remission from lymphoma but was wheelchair-dependent, with persistent paralysis and spinal cord atrophy.Comment  This case highlights a rare and severe form of CAR T-cell-related neurotoxicity, manifesting as transverse myelitis in the absence of a marked inflammatory response. The refractory course and lack of standard treatment options underscore the need for greater awareness, reporting, and further research into atypical neurological complications of CAR T-cell therapy.
SN  - 1230-2813
SN  - 2720-5371
ER  -